Self-donning sphygmomanometer cuff

ABSTRACT

A self-donning sphygmomanometer cuff with adjustable, selfdonning features which simplify the attachment of the cuff to an arm or leg by the person utilizing said cuff. The cuff has an elasticized strip portion secured at one end to a non-stretchable portion of the cuff body which, in combination with cooperating connector means provides adjustable initial cuff tension around the appendage before it is secured to the appendage by conventional means.

Unite States Hurwitz atent [451 June 13, 1972 SELF-DONNING SPHYGMOMANOMETER CUFF [72] Inventor:

Auburndale, Mass. 02166 [22] Filed: April 7, 1970 [21] Appl. No.: 26,283

Mathew Hurwit'z, 63 Oakland Avenue,

1,282,908 10/1918 Miller 128/205 S X 3,467,077 9/1969 Cohen ..l28/2.05 C 2,339,239 1/1944 camiichael. ..l28/327 X 1,606,841 11/1926 Newton ..128/327 2,896,610 7/1959 Speelman. .....l28/2.05 C 3,258,009 6/1966 London ..128/2.05 C

Primary Examiner-Kyle L. Howell Atzorney-Nathan N. Kraus and Joseph R. Marcus [5 7] ABSTRACT A self-donning sphygmomanometer cuff with adjustable, selfdonning features which simplify the attachment of the cuff to an arm or leg by the person utilizing said cuff. The cufl" has an 56] keferenc'es Cited elasticized strip portion secured at one end to a non-stretchable portion of the cuff body which, in combination with UNITED STATES PATENTS cooperating connector means provides adjustable initial cuff tension around the appendage before it is secured to the ap- 3,279,459 10/1966 Schenker 1 28/205 C pendage by conventional means. 2,714,379 8/1955 Raines ....128/2.05 G 3,315,662 4/1967 Buffington 128/205 G 2 Claims, 6 Drawing Figures 1 SELF-DONNING SPHYGMOMANOMETER CUFF BACKGROUND THE INVENTION This invention relates to a sphygmomanometer cuff with adjustable, self-donning features which greatly simplify attachment of the cuff'by the subject utilizing the cuff on his arm or leg. This invention more particularly relates to a sphygmomanometer cuff having anadjustable elasticized strip portion secured at one edge to the non-stretchable portion of the cuff body which provides adjustable initial tension around the appendage prior to securing the cuff.

In the measurement of human blood pressure by the conventional techniques, a pneumatic occluding cuff of unyielding fabric material having within it an inflatable bladder is applied to the upper arm or upper leg. The cuff bladder is then inflated to a pressure exceeding the systolic pressure and is then vented slowly while the technician listens for sounds via a stethoscope held over the artery just downstream of the cuff. The technician then usually records systole as the cuff pressure when the first phase of Korotkoff sounds (tapping) is heard and diastole as the cufi pressure when the fourth phase of Korotkoff sounds (muffling) is heard. The Riva-Rocci/Korotkoff technique by far is themost widely accepted and widely practiced method of sphygmomanometry. This technique is known to be sensitive to errors from a host of causes. One especially significant-class of error is attributable to the design of the conventional cuff and the way the cuff is often applied to the limb. i

Cuff errors in sphygmomanometry generally stem from use of a cuff of the wrong width for the girth of the limb (too wide a cuff gives low readings; too narrow a cuff gives high reading). F urther,'when a cuff is too loosely applied to the limb so that part of the pneumatic pressure is being used to distend the bladder of the cuff rather than to occlude the limb, high readings are produced. Also, inadvertent rotation of the cuff on the limb during the application of the cuff may occur so that the bladder may not be applied over the artery. In addition, conventional cuffs are difficult to apply to tapering limbs. Thus, insuring the proper initial tension or snugness of the cuff on a limb is important for clinical accuracy as is preventing the cuff from being used on limbs which are too large for the cuffs width. 7 I I In the prior art sphygmomanometer cuff devices, various adjusting means have been suggested for securing these cufis to the limb. For example, in one prior art patent, the patentee shows an elastic panel fitted permanently, that is sewn, to the cuff between one end and the mid-point of the cuff so as to form the cuff into a loop of fixed size adjustable only to the extentthat the elastic member can stretch to accommodate the limb. My invention uses an elastic strip portion but does not have both ends of the elastic stitched to the cuff. My invention includes a significantly different approach which provides improved performance and accuracy not achievable with the prior art cuffs. Specifically, my self-donning sphygomomanometer cuff has a means for adjusting the initial cuff circumference and the cuff shape together with an elasticized strip portion member which provides the advantages of minimizing the normally occurring errors in present day sphygmomanometry using the prior art cuffs.

SUMMARY OF THE INVENTION Accordingly, it is an object of my invention to provide an improved sphygomomanometer cuff so that the cuff of my invention can be used significantly more easily and more accurately than prior art cuffs.

It is a further object of my invention to provide a selfdonning sphygomomanometercuff that is a significant improvement over prior art cufi" designs by providing means enabling the practitioner touse the cuff with much greater ease, precision, and reproduceability than was heretofore possible. Further, by design, my cuff can be made in such a way that it can be conveniently used only on limbs of the proper girth for the particular cuff width.

A further advantage of my cuff is that it can be applied in a clinically correct manner to the subject's limb by the subject himself easily and quickly with no assistance. This selfdonning feature of my cuff is especially important because increasing numbers'of physicians recommend, for example, that many of their hypertensive patients measure their own blood pressure at home inasmuch as ithas been'proven in studies that blood pressure readings are more accurately taken and are usually significantly lower in the familiar environment of the home as compared to the unfamilar clinical environment. Further, many individuals have to self-take their blood pressure as part of their diagnostic program or their program to adjust dosages of corrective medication or to monitor the effects of special diets or the like. Further, as will become more apparent in the detailed description of my invention, my cuff prevents improper use of the cuff by virtue of an adjustable feature having carefully limited dimensional capacity which prevents the cuff from being used conveniently on the wrong size limb. The cufi of my invention snugly accommodates the limb prior to its being locked or secured around the limb in place by conventional means. It is these very features of limited adjustability and self-contained means in the cuff for providing proper tension prior to securing the cuff which makes my cuff so easy for a subject to put on his own limb with accuracy and reproducability.

Therefore, the present invention provides a self-donning sphygmomanometer cuff for use on an appendage of a living being which comprises,'in combination: (a) a pair of strips of non-stretchable, flexible material in face-to-face relation secured to each other along their edges forming a nonstretchable cuff body; (b) inflatable bladder means positioned within an intermediate portion of said cuff body; (0) first connector means carried by said non-stretchable portion of said body on an intermediate portion of said body; ((1) an elasticized strip portion secured at one edge to said nonstretchable portion of said cuff body at one end thereof and having co-operating first connector means for providing an adjustable initial tension around the appendage prior to securing said cuff; and, (e) second connector'means carried by said cuff body adjacent to said first connector means upon said non-stretchable portion of said body and having co-operating second connector means disposed along an intermediate portion of said cuff on the other side of said cuff for securing said cufi to the appendage so as to place the ends of said cuff body in overlapping relation to said intermediate portion of said body.

Other objects and advantages of my invention will become apparent from the following description when the same is considered in connection with the accompanying drawings.

DESCRIPTION OF THE DRAWINGS Referring now to the drawings,

FIG. 1 is a perspective view of the inside of the self-donning sphygmomanometer cuff;

FIG. 2 is a perspective view of the outside of the selfdonning sphygmomanometer cuff;

FIG. 3 is a perspective view of the self-donning sphygmomanometer cuff showing the ends of the cuff in overlapping relation;

FIG. 4 is a perspective view of the self-donning sphygmomanometer cuff showing the cuff being slipped onto an appendage after the cuff has been secured by connector means for providing an adjustable initial tension around the appendage prior to securing the cuff on the upper arm;

FIG. 5 is a perspective view of the self-donning sphygmomanometer cufi' in an operative position on an upper portion of the arm; and,

FIG. 6 is an exploded perspective view of the self-donning sphygmomanometer cuff. 7

Referring now generally to the drawings, the numeral 1 indicates generally, a self-donning sphygmomanometer cuff such as is illustrated in FIGS. 1 through 6.

As shown in FIGS. 1 and 2, the self-donning sphygmomanometer cuff 1 comprises a pair of strips 2 and 3 of nonstretchable flexible material in face-to-face relation secured to each other along their edges forming a non-stretchable cuff body. Typically, the cuff may be made from woven fabric or the like or from a flexible plastic that is relatively nonstretchable or the cuff may be made from a cotton twill-like material. Typically, the cuff for the adult patient will be approximately 6 inches wide by approximately nineteen inches long and will be of a sufficiently heavy material such as an 8.5 ounce all cotton twill-like material.

Inflatable bladder means 4 (partially shown) with bladder connectors 5 and 6 is positioned within an intermediate portion of the cuff body. The bladder means 4 is preferably made of an elastomeric material and is inserted between strips 2 and 3 of cuff body 1 in an intermediate portion of the cuff body. Bladder connectors 5 and 6 extend from bladder 4 and may carry suitable fittings by which the bladder connectors 5 and 6 may be connected to a bulb (not shown) for inflating bladder 4 and to a suitable pressure gage such as a mercury manometer (not shown) or an automatic sphygmomanometer (not shown), by which the air pressure in the bladder may be measured.

First connector means 7 are carried by the non-stretchable portion of the cuff body on an intermediate portion of the body on the arm side of the cuff as is shown in FIG. I. These first connector means 7 may comprise a plurality of, for example, snap fastener elements and may be arranged in any geometric pattern that is desirable. I have found that when approximately five snap fastener elements are located along one edge of the cuff as shown in FIG. 1 and an additional five snap fastener elements are located directly across from the first group of five snap fastener elements, and when these are approximately one inch apart, excellent results are obtained utilizing the cuff of my invention. Typically, these connector means 7 are located approximately five-eighths inches from the outside edge of each side of the cuff as is shown in FIG. 1.

An elasticized strip portion or panel of elastic fabric 8 is secured at one edge by, for example, binding 9 to the nonstretchable portion of cuff body 1 at one end thereof and the strip has co-operating first connector means or fastener elements 10 on binding end 10a for providing an adjustable initial tension in co-operation with complementary fastener elements or connector means 7 around the appendage prior to securing said cuff. Co-operating first connector means 10 of the readily detachable fastener assemblies may also comprise a plurality of snap fastener elements and may be located on the elastic strip itself.

The elasticized strip portion may be stretchable in both a longitudinal and transverse direction or in a longitudinal direction only. When the elasticized strip portion 8 that is secured to the non-stretchable portion of cuff body 1 is stretchable in a transverse direction alone, my cuff becomes inoperative in its intended self-donning mode.

Second connector means 11 are carried by cufi body 1 on the arm side of the cuff adjacent to the first connector means 7 upon the non-stretchable portion of cuff body 1 and has cooperating second connector means 12 disposed along an intermediate portion of cuff l on the outside portion of the cuff for securing the cuff to the appendage so as to place the ends of the cuff body in overlapping relation as shown in FIG. 3, to the intermediate portion of cufi body I.

The second connector means 11 and second co-operating connector means 12 are, preferably, multi-positionally adjustable fastening means. Preferably, these multi-positionally adjustable fastening means are of the type manufactured by American Velcro Company, Manchester, New Hampshire, under the trademark Velcro, although it is understood that any other suitable fastening means may be used in my cuff without departing from the scope of my invention. However, the Velcro fastener is preferred since it is extremely adjustable and may be re-used over and over again. Typically, the second connector means 11 are of Velcro hooked material which comprises a multitude of small barbs secured to a fabric backing which is secured to strip 2. The second co-operating connector means 12 are preferably the Velcro pile material that comprises a multitude of small loops secured to a fabric backing which is secured to the outside of the cuff on strip 3.

Referring now to FIGS. 3 and 4, the initial unstretched diameter of my cufi can be adjusted to correspond to the girth of the patients limb. This means that regardless of the girth of the limb to which my cuff is applied, the initial tension, prior to securing the second connector means and second cooperating connecting means is essentially the same. As compared to the prior art cuffs, the prior art cuffs are extremely snug on an obese limb and rather loose on a slender limb because these cuffs are formed into a loop of fixed size since the elastic panels utilized in the prior art are sewn directly to an intermediate portion of the cuff.

By virtue of the rows of first connector means 7, typically snap fasteners on my cuff, my cuff can be pre-formed not only into a cylindrical or annular shape suitable for the average limb but it can also be formed into a truncated conical shape for highly tapered limbs which are very common on obese subjects. The prior art cuffs are fixed into a loop of cylindrical or annular geometry and therefore will apply uneven pre-tension to tapered limbs so that the cuff will be tight around the wide portion of the limb and too large and loose where the limb is slender. Further, because my cuff can be totally opened it can be more easily put on and removed by the subject. This is an especially important feature when the subject is perspiring heavily inasmuch as that under such a condition the elasticized cuff of fixed diameter is difficult if not painful to remove. My cufi eliminates this problem.

Further, my cuff uses a relatively short length of an elastic material having a limited extension, preferably about 1 inches of stretch, which in combination with the adjustable circumference provided by the rows of first connector means 7 makes the cuff difficult to apply to limbs of too large or too slender girth for the width of the particular cuff. For a standard 6 inch wide cuff wherein the elastic means 8 is 3 /2 inches long and has a stretching capacity of 1 /2 inches, the most remote of the connectors 7a should be located 14 inches from the cooperating first connectors 10 which are on the binding at the free edge of the elastic panel 8. If these dimensions are observed, the cuff, when adjusted to its largest circumference, will just fit a limb whose diameter is 20 percent smaller than the 6 inch width of the cuff. this is the clinically accepted limit for a 6 inch wide cuff. If an attempt is made to attach the cuff to a limb of greater girth, the cuff will not fit unless it is unsnapped and used in the old-fashioned way. Thus my cuff cannot be used conveniently in its intended mode on limbs which are too obese for its width. Similarly for the same standard 6 inch wide cuff, the innermost connectors 71; should be located 10 inches from the cooperating first connectors 10. Thus, when an attempt is made to don the cuff on too small a limb for the 6 inch cuff width, it will again be found that the cuff cannot be used conveniently in its intended mode. This means that when my cuff is adjusted to its largest cylindrical diameter it will not fit limbs where the girth of the subject too greatly exceeds this diameter. Thus, inadvertent wrong use of a cuff on too large a limb which can cause blood pressure errors on the high side can be eliminated. Further, when my cuff has its first connector means 7 so fastened with co-operating first connector means 10 so as to form the cuff into its minimum diameter, the cuff will fit sloppily on too slender a limb. This provides an instant warning that the cuff is too wide for the girth of that limb and the user is thus informed he should go to a narrower cuff for accuracy. The accuracy of the blood pressure measurement is affected in that failure to use an appropriately narrow cuff for a slender limb causes blood pressure errors on the low side. Thus, the prior art cuffs having fixed circumference elasticized loops have little or no discreet limitation on the maximum and minimum girth of limb onto which the cuff can be placed.

Referring now to FIGS. 4 and 5, when the subject has secured the co-operating first connector means to the proper first connector means7 and slides the cufi onto his arm as shown in FIG. 4, he may then locate the cuff in the correct position and then fasten second connector means 11 to cooperating second connector means 12 so that the cuff is in the operative position shown in-FIG. 5 for the blood pressure measurement.

Referring now to FIG. 6, my cuff body may include an elasticized insert member located within the cuff body which provides a supporting pocket for a microphone or stethescope head(not shown). The supporting pocket is shown as the numeral l4 and the elastic fabric 15 may have fastening means 15a and co-operating fastening means 15b for securing the microphone or stethescope head snugly in the pocket. As shown in the exploded view, co-operating first connector means 10 are located on a binding 10a that may have an insert 10b such as bone or steel for support. This binding is secured to elasticized strip portion 8 which may be approximately 3 /2 inches wide and the elastic fabric 8 may be secured to the cuff body by binding at one end of the cuff body. Since the inside (arm or leg side) of the cuff is shown, first connector means 7 are shown carried by the non-stretchable portion of the cuff body on an intermediate portion of the cuff body and the second connector means 11, typically Velcro hooked material, is shown on the cuff body adjacent to the first connector means 7. The second connector means are on the reverse side of the cuffas shown in FIG. 2.

PREFERRED EMBODIMENT In a particularly preferred embodiment of my invention, this invention provides a self-donning sphgmomanometer cuff for use on an appendage of a living being which comprises, in combination, a pair of strips of non-stretchable, flexible material in face-to-face relation secured to each other along their edges forming a non-stretchable cuff body, an inflatable bladder means positioned within an intermediate portion of the cuff body, first connector means comprising a plurality of snap fastener elements carried by the non-stretchable portion of the body on an intermediate portion of the cuff body, an elasticized strip portion secured at one edge to the nonstretchable portion of the cuff body at one end, said elasticized strip portion being stretchable only in a longitudinal direction, co-operating first connector means comprising a plurality of snap fastener elements for providing an adjustable initial tension around the appendage prior to securing the cuff, second connector means comprising multi-positionally adjustable fastening means carried by the cuff body adjacent to the first connector means upon the non-stretchable portion of said body and having co-operating second connector means comprising multi-positionally adjustable fastening means disposed along an intermediate portion of the cuff on the other side of the cuff for securing the cuff to the appendage so as to place the ends of the cuff body in overlapping relation to the intermediate portion of the cuff body.

It is apparent that my self-donning sphygmomanometer cuff has a means for adjusting the initial cufi circumference and the cufi shape together with an elasticized strip portion member providing advantages of minimizing the normally occurring errors in present day sphygmomanometry.

Various changes coming within the spirit of my invention may suggest themselves to those skilled in the art; hence I do not wish to be limited to the specific embodiment shown and described or uses mentioned, but intend the same to be merely inner face and an outer face, and said band being adapted to be applied in encompassing relation to a llm with the inner face thereof adjacent to said limb, said band being comprised of a pocketed intermediate portion formed of a pair of strips of non-stretchable flexible material with inflatable bladder means positioned between said strips,

. a panel of elastic fabric, stretchable at least in a longitudinal direction, extending from one edge of said intermediate portion and terminatingin an end provided with fastener elements of readily detachable fastener assemblies on the outer face of said end, and

d. a non-stretchable portion extending from the opposite edge of said intermediate portion; a plurality of relatively closely-spaced fastener elements, complementary to each of said first-mentioned fastener elements of said readily detachable fastener assemblies, disposed on the inner face of said band at said intermediate portion, in rows parallel to the longitudinal edges thereof, adapted for selective engagement with the fastener elements on said end, to control independently the initial circumference of the cuff at the opposite edges of the band and the consequent shape and initial tension and snugness of the fit of the cuff around the limb,

f. said last-mentioned complementary fastener elements being deployed in said rowsso that the outermost and innermost of said complementary fastener elements provide means for controlling the dimensional limits of said cufi to preclude application of said cuff to limbs which are either larger or smaller than the size range for which said cuff is intended to be applied, and

. a secondary fastening device for fixing the final tension of said cuff on said limb comprising adjustable fastening engaging means on the outer face of said band at that end of said intermediate portion which is adjacent to said elastic panel cooperating with complementary engaging means on said last-mentioned non-stretchable portion of said band.

2. An apparatus as set forth in claim 1, wherein said firstmentioned readily detachable fastener assemblies are constituted by the male and female elements of snap fasteners. 

1. A self-donning sphygmomanometer cuff for uniformly pretensioned application to limbs of different sizes and tapers, which comprises a. a fully open band of flexible sheet material having an inner face and an outer face, and said band being adapted to be applied in encompassing relation to a limb with the inner face thereof adjacent to said limb, said band being comprised of b. a pocketed intermediate portion formed of a pair of strips of non-stretchable flexible material with inflatable bladder means positioned between said strips, c. a panel of elastic fabric, stretchable at least in a longitudinal direction, extending from one edge of said intermediate portion and terminating in an end provided with fastener elements of readily detachable fastener assemblies on the outer face of said end, and d. a non-stretchable portion extending from the opposite edge of said intermediate portion; e. a plurality of relatively closely-spaced fastener elements, complementary to each of said first-mentioned fastener elements of said readily detachable fastener assemblies, disposed on the inner face of said band at said intermediate portion, in rows parallel to the longitudinal edges thereof, adapted for selective engagement with the fastener elements on said end, to control independently the initial circumference of the cuff at the opposite edges of the band and the consequent shape and initial tension and snugness of the fit of the cuff around the limb, f. said last-mentioned complementary fastener elements being deployed in said rows so that the outermost and innermost of said complementary fastener elements provide means for controlling the dimensional limits of said cuff to preclude application of said cuff to limbs which are either larger or smaller than the size range for which said cuff is intended to be applied, and g. a secondary fastening device for fixing the final tension of said cuff on said limb comprising adjustable fastening engaging means on the outer face of said band at that end of said intermediate portion which is adjacent to said elastic panel cooperating with complementary engaging means on said lastmentioned non-stretchable portion of said band.
 2. An apparatus as set forth in claim 1, wherein said first-mentioned readily detachable fastener assemblies are constituted by the male and female elements of snap fasteners. 